Advocates seek $100-million for youth suicide-prevention

Investing in youth suicide-prevention programs in 25 Canadian communities over the next five years could save 127 lives and more than $200 million annually, a spokesman for a national mental health charity told the House of Commons Standing Committee on Finance.

Partners for Mental Health, a nongovernmental organization that spun out of the Mental Health Commission of Canada, is urging the Liberal government to create a $100-million youth suicide-prevention fund in its upcoming budget.

Coupled with matching dollars from provinces and territories and philanthropists, the fund would establish community-wide prevention programs based on a successful approach called the Nuremberg model, Ian Manion, a psychologist at the Royal Ottawa Hospital, told the standing committee on Feb. 19. (Manion, who chairs the Child and Youth Advisory Committee for Partners for Mental Health, is also the former executive director of the Ontario Centre of Excellence for Child and Youth Mental Health.)

Suicide is the second-leading cause of death among Canadian children and youth aged 10–24, Manion told the committee. In some First Nations and Inuit communities, suicide rates are 4–10 times the national average. In Nunavut, the suicide rate for young men aged 15–19 climbs to a staggering 40 times the national rate for that age range.

“We do believe [the government] has to be sending a message across the country that this is an issue and that we cannot sit by idly anymore,” Manion said.

The Nuremberg Alliance Against Depression implemented its suicide prevention approach in Nuremberg, Germany, in 2001. The model emphasized four levels of prevention: building capacity among primary care physicians; education campaigns to reduce mental health stigma; suicide-prevention training for community “gatekeepers,” including teachers, religious leaders, social workers and family members; and targeted support for those at greatest risk, including people who have already attempted suicide.

An evaluation of the model concluded that after two years, it resulted in a 24% reduction in suicides and suicide attempts, Manion said in an interview with CMAJ.

Partners for Mental Health used the 24% reduction figure to estimate the savings the model could achieve in Canada. In 2011, 528 children and youth aged 10–24 took their own lives, and suicide has an annual direct and indirect economic cost of approximately $2.4 billion per year, the organization said in its committee brief.

In response to the Nuremberg model’s success, 16 European countries formed the European Alliance Against Depression in 2004 to fund community-wide suicide-prevention programs with the same approach.

Public concern and the willingness of philanthropists and some provincial and territorial parties to join this effort means now is the critical time to act, rather than waiting for Canada to establish a national suicide-prevention strategy, said Manion.

The Public Health Agency of Canada is poised to roll out a strategy but it will not include an implementation plan, Manion said. Successful strategies, such as the one Quebec employed to cut its youth suicide rate by half from 1999 to 2010, usually contain targets and timeframes and assign responsibility for actions.

“Too often, we come across a strategy with no implementation. The public is very tired of the rhetoric part of that and is really poised for some action,” Manion told the committee.

Although Liberal members on the committee did not indicate whether the government will agree to the request, they acknowledged the severity of the issue.

“We can all agree, across party lines, that this is a serious issue that needs to be addressed,” said Francesco Sorbara, the Liberal MP for Vaughan-Woodbridge.